A PROSPECTIVE-STUDY OF THE SEROPREVALENCE OF BORRELIA-BURGDORFERI INFECTION IN PATIENTS WITH SEVERE HEART-FAILURE

被引:36
作者
SONNESYN, SW
DIEHL, SC
JOHNSON, RC
KUBO, SH
GOODMAN, JL
机构
[1] UNIV MINNESOTA,SCH MED,DEPT MED,CARDIOL SECT,MINNEAPOLIS,MN 55455
[2] UNIV MINNESOTA,SCH MED,DEPT MICROBIOL,MINNEAPOLIS,MN 55455
关键词
D O I
10.1016/S0002-9149(99)80814-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Lyme disease, caused by the spirochete Borrelia burgdorferi, can disseminate from the initial cutaneous infection to involve the heart, nervous system, and joints. Lyme disease has been associated with cardiac involvement in up to 8% of patients.(1) Although the most common cardiac complications are conduction system disturbances, pericarditis and myocarditis have also been reported.(2) In addition, 1 study reported lower resting heart rates in asymptomatic B. burgdorferi seropositive persons than in seronegative persons.(3) B. burgdorferi causes myocarditis in both C3H mice(4) and in guinea pigs(5) and has been cultivated from an endomyocardial biopsy of a patient with cardiomyopathy and serologic evidence of exposure to B. burgdorferi.(6) A European group reported that ceftriaxone therapy was followed by improvement in left ventricular ejection fraction in 8 of 9 B. burgdorferi seropositive patients with dilated cardiomyopathy.(7) These findings raise the possibility that B. burgdorferi may be an important etiologic agent of otherwise unexplained cardiomyopathy in endemic areas. The University of Minnesota is a referral center for patients with severe cardiomyopathy and is located in a region where Lyme disease is endemic. To evaluate the possible role of B. burgdorferi as an etiologic agent in chronic severe heart failure, we prospectively studied 175 consecutive patients referred to the University of Minnesota for evaluation of heart failure and possible cardiac transplantation. We hypothesized that if B. burgdorferi was an etiologic agent among our heart failure patients with idiopathic cardiomyopathy, they should have higher seropositivity rates than patients with ischemic heart disease or healthy controls.
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页码:97 / 100
页数:4
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  • [1] Steere A.C., Batsford W.P., Weinberg M., Alexander J., Berger H.J., Wolfson S., Malawista S.E., Lyme carditis: cardiac abnormalities of Lyme disease, Ann Intern Med, 93, pp. 8-16, (1980)
  • [2] Olson L.J., Okafor E.C., Clements I.P., Cardiac involvement in Lyme disease: manifestations and management, Mayo Clin Proc, 61, pp. 745-749, (1986)
  • [3] Vidaillet H.J., Broste S.K., Marx J.J., McCarty P.A., Layde P.M., Mitchell P.D., Dlesk A., The 12-lead electrocardiogram of “bealthy” ambulatory subjects with positive Lyme immunoserology, Am J Cardiol, 71, pp. 1249-1251, (1993)
  • [4] Amstrong A.L., Barthold S.W., Persing D.H., Beck D.S., Carditis in Lyme disease susceptible and resistant strains of laboratory mice infection with Borrelia burgdorferi, Am J Trop Med Hyg, 47, pp. 249-258, (1992)
  • [5] Sonnesyn S.W., Manivel J.C., Johnson R.C., Goodman J.L., A guinea pig model for Lyme disease, Infect Immun, 61, pp. 4777-4784, (1993)
  • [6] Stanek G., Klein J., Bittner R., Glogar D., Isolation of Borrelia burgdoiferi from the myocardium of a patient with longstanding cardiomyopathy, N Engl J Med, 322, pp. 251-252, (1990)
  • [7] Gasser R., Dusleag J., Reisinger E., Stauber R., Feigl B., Portgratz S., Klein W., Furian C., Pierer K., Reversal by ceftriaxone of dilated cardiomyopathy Borrelia burgdoiferi infection [letter], Lancet, 339, pp. 1174-1175, (1992)
  • [8] Gill J.S., Johnson R.C., Immunologic methods for the diagnosis of infections by Borrelia burgdoiferi (Lyme disease), Manual of Clinical Laboratory Immunology, pp. 452-458, (1992)
  • [9] Engstrom S., Shoop E., Johnson R.J., Immunoblot interpretation criteria for sero· diagnosis of early Lyme disease, J Clin Microbiol, 33, pp. 419-422, (1995)
  • [10] Dressler F., Whalen J.A., Reinhardt B.N., Steere A.C., Western blotting in the serodiagnosis of Lyme disease, J Infect Dis, 167, pp. 392-400, (1993)